Organization
WALLER MEDICAL CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PON SATITPUNWAYCHA M.D., F.A.C.S. (DOCTOR)
(281) 890-9146
Entity
Organization
Contact information
Practice address
11301 FALLBROOK DR, STE 101, HOUSTON, TX 77065-4237
(281) 890-9146
(281) 894-1115
Mailing address
11301 FALLBROOK DR, STE 101, HOUSTON, TX 77065-4237
(281) 890-9146
(281) 894-1115
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F2902
TX
Other
Enumeration date
03/15/2007
Last updated
08/22/2020
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